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物理治疗主导的新生儿体外膜肺氧合中的肺部超声:一项病例研究。

Physiotherapy-led lung ultrasound in neonatal extra-corporeal membrane oxygenation: A case-study.

作者信息

Shkurka Emma, Nolan Wendy

机构信息

Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.

出版信息

Perfusion. 2023 Jul;38(5):1092-1094. doi: 10.1177/02676591221094410. Epub 2022 May 23.

Abstract

There is a growing body of evidence to support the use of point of care lung ultrasound (LUS) in adult patients receiving extra-corporeal membrane oxygenation (ECMO). However, literature supporting the use of LUS in neonatal and paediatric ECMO patients is limited. We report the use of physiotherapy-led LUS in a neonatal ECMO patient. The baby required veno-arterial ECMO for long-segment tracheal stenosis and presented with complete right lung collapse. In this situation real time, bedside imaging enabled timely and specific physiotherapy treatment to be implemented. LUS also allowed immediate reassessment and subsequent improvement to be determined. This negated the requirement for an additional, pre-surgery chest X-ray, reducing radiation exposure. This case-study highlights LUS as an important tool for health professionals caring for neonatal and paediatric ECMO patients. Future research should include further development of population specific LUS scoring systems.

摘要

越来越多的证据支持在接受体外膜肺氧合(ECMO)的成年患者中使用床旁肺部超声(LUS)。然而,支持在新生儿和儿科ECMO患者中使用LUS的文献有限。我们报告了在一名新生儿ECMO患者中由物理治疗师主导使用LUS的情况。该婴儿因长段气管狭窄需要静脉-动脉ECMO,并出现了右肺完全塌陷。在这种情况下,实时床旁成像能够及时实施针对性的物理治疗。LUS还能立即进行重新评估并确定后续的改善情况。这消除了额外进行术前胸部X光检查的必要性,减少了辐射暴露。本病例研究强调了LUS作为护理新生儿和儿科ECMO患者的卫生专业人员的重要工具。未来的研究应包括进一步开发针对特定人群的LUS评分系统。

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